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The PURLS system was developed in a collaborative partnership of the Family Physicians Inquiries Network (FPIN) and The Journal of Family Practice as an objective of the University of Chicago Institute for Translational Medicine, funded through a Clinical Translational Science Award from the National Institutes of Health. We have developed a knowledge translation system called PURLs that exclusively targets newly published research expected to actually change family medicine and primary care practice. For an example of a published PURL,click here.

PURLs generate new evidence-based recommendations for practice for family physicians and other primary care clinicians. PURLs are stimulated by the publication of new research that meets criteria for a new recommendation to change practice. The completed PURLs are published in The Journal of Family Practice as well as Evidence-Based Practice. To learn more about PURLs published in JFP go HERE

What are the criteria for PURLs?

Each PURL must meet six criteria:

Relevant: Relevance to family medicine and primary care.

Valid: Scientific validity, including integration of prior research.

Change in Practice: Leads to a change from the current prevailing practice.

Applicable to Medical Care: The new practice approach is applicable in a medical care setting.

Implementable: The new practice is immediately applicable.

Clinically Meaningful: Expected benefits outweigh expected harms.

What is the purpose of the PURLs Surveillance System?

The purpose of the PURLs Surveillance System is to engage communities of clinicians and methodologists in the identification, evaluation, and dissemination of PURLs; and to accelerate the translation of new research findings into clinical practice.

What is the process for identifying and evaluating PURLs?

There are five steps in the identification and evaluation of a PURL:

Nomination of a Potential PURL: Many designated family physicians perform literature surveillance of multiple sources for new research and nominate studies via e-mail listserv that seem like they might change practice as judged by reading the abstract. If the PURLs Editor agrees, then the study is assigned for formal review as a Potential PURL.

Review of a Potential PURL: This includes a formal critical appraisal and literature review which is recorded on a standardized critical appraisal form (the Potential PURL Review Form), submitted to the PURLs Editor and presented to a peer group at a PURL Jam, similar to a journal club format. If the study seems as though it will meet criteria for a PURL and is approved by the PURLs Editor, it goes to the next step, pending PURL for review.

Pending PURL: First the review forms are peer reviewed and sent to EBP and published as Diving for PURLs. Second the PURLs editor sends the review to The Journal of Family Practice. The study and written summary of the findings from the first three steps of the review are evaluated by the JFP editor, who either accepts it as a topic for a PURL manuscript for publication or not.

PURL Manuscript Preparation: If the JFP Editor accepts the study as a PURL, then a manuscript summarizing the practice change, the summary of the study, and our analysis is written for publication in JFP as a PURL by a PURL approved author.

What sources are used to nominate Potential PURLs?
The PURL surveillance team, a volunteer group of family medicine physicians, nominates articles from over 40 primary journals and secondary sources. The nomination listserv consists of over 50 physicians around the country who weigh in on the PURL hood of nominations.

In addition, nominations are accepted from any peer-reviewed medical journal or pre-synthesized evidence-based source. Our goal is to identify every research study that should lead to a change in practice for family physicians and other primary care clinicians so if we have missed any studies through our formal surveillance systems, we want to hear about them. If we have missed a study we will review it and seriously consider it as a PURL.

How does the system work?

Many steps and many people are involved in selecting and producing a PURL. The methodology includes surveillance of primary and secondary literature; critical appraisal of the potential PURLs identified; review of the related literature; and a vigorous peer review, clinical review, and editorial review process.

Who should I contact for more information?

Contact the PURLs Project Manager, Laura Conlee Russell atPURLs@fpin.org, for more information. To find the latest PURL published in JFP, click here.

FPIN is looking for Peer Reviewers! There are many benefits to peer reviewing a manuscript, among some of them are: Peer review is reportable as faculty scholarly activity on annual ACGME reports, Peer review may fulfill local university scholarly activity requirements, Peer review can be included on curriculum vitae, Peer review provides further experience with the medical literature that can improve skill in critical appraisal and medical writing. Interested? To sign up to become an FPIN Peer Reviewer, go HERE and click "Register Now".